Drug interactions
Diazepam intranasal + Remifentanil
Severity: Major
Diazepam intranasal and Remifentanil: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Benzodiazepines combined with opioids carry a labeled warning for profound sedation, respiratory depression, coma and death. Remifentanil's potency makes this particularly relevant.
What this interaction means in plain words
Diazepam intranasal and Remifentanil can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive CNS depression from GABA-A potentiation and mu-opioid agonism.
What to do
Use only if alternatives are inadequate, with the lowest doses and shortest duration, and monitor continuously with respiratory support available.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Remifentanil
- Alvimopan + Remifentanil Contraindicated
- Isocarboxazid + Remifentanil Contraindicated
- Olanzapine / samidorphan + Remifentanil Contraindicated
- Phenelzine + Remifentanil Contraindicated
- Benzhydrocodone / acetaminophen + Remifentanil Major
- Brexanolone + Remifentanil Major
Frequently asked questions
Can I take Diazepam intranasal with Remifentanil?
MediHelp rates the interaction as major. Diazepam intranasal and Remifentanil can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Benzodiazepines combined with opioids carry a labeled warning for profound sedation, respiratory depression, coma and death. Remifentanil's potency makes this particularly relevant.
How serious is the interaction between Diazepam intranasal and Remifentanil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use only if alternatives are inadequate, with the lowest doses and shortest duration, and monitor continuously with respiratory support available.
What other medicines interact with Remifentanil?
MediHelp also lists interactions of Remifentanil with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Remifentanil page.
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